Smart Surgical Knife Detects Cancer Cells in Seconds

Written by Nina Lincoff on July 18, 2013

Cancer is an affliction with name recognition, in part because it's harrowing, but also because it's strikingly common. As of January 2009, more than 12.5 million living Americans had been diagnosed with cancer, according to the American Cancer Society. In the U.K., more than 300,000 new cancer cases are diagnosed every year.

If doctors determine that completely removing a tumor is the best course of cancer treatment, they perform curative surgery with the goal of removing every last bit of cancerous tissue. Unfortunately, differentiating between cancerous and healthy tissue isn’t always black and white. At least, not before Hungarian researchers invented the “iKnife.”

In a recent study published in Science Translational Medicine, researchers announced that their iKnife prototype could correctly tell the difference between cancerous and healthy tissues on the spot 100 percent of the time. While the study was small—involving only 81 cases—it shows a marked improvement over current surgical standards.

Of breast cancer patients undergoing lumpectomies, or the removal of suspicious lumps, 20 percent must undergo a second surgery to remove cancerous tissue surgeons missed the first time around, according to a 2012 study published in the British Medical Journal.

The edges of a tumor aren’t always easy to detect, so surgeons often send a sample of the patient’s tissue to a histologist—while the patient remains under anesthesia—to confirm whether the tissue is cancerous or healthy, according to press materials accompanying the study. However, with the iKnife, a surgeon can be alerted within seconds if they’re infringing on healthy tissue or leaving cancerous cells behind.

If a knife that detects differences between malignant and healthy tissues in real-time isn’t forward thinking enough, consider how the iKnife, short for "intelligent knife," works: by reading smoke signals in the air.

Is 'iSurgery' the Wave of the Future?

In this case, sending smoke signals is a good thing. The iKnife works by utilizing a technique called rapid evaporative ionization mass spectrometry (REIMS). During surgery, aerosol or smoke is released when incisions in the tissue are cauterized, a process used to slow bleeding by inflicting a small burn.

Different chemicals in the smoke refract light differently, producing a unique light spectrum. Cancerous tissues have a different molecular makeup than healthy tissues, so when smoke is released, different light patterns emerge.

Using REIMS, within seconds of making and cauterizing an incision with the iKnife, a surgeon can tell if he's cutting into the correct tissues. And the REIMS technique will help scientists gather other helpful data on the makeup of cancerous tumors to boot.

“In addition to real-time diagnostic information, the spectra provided additional information on divergent tumor biochemistry that may have mechanistic importance in cancer,” the study authors wrote.

These findings suggest that the new tool is reliable enough for widespread use in operating rooms, and the Hungarian team is now seeking venture capital investors and more patients to begin a larger clinical trial.